Judith V Wall, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW3067 Issued in FL

Practice address

759 SW Federal Hwy
#203
Stuart, FL 34994-2914

Phone

(772) 219-0779

Fax

(772) 221-7885

NPI assigned

Jan 18, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• A & B Counseling Services LLC

  • Adult Mental Health Clinic/Center
  • Fort Lauderdale, FL
  • NPI 1508327628
  Medicare reassignment NPD
• A & B Counseling LLC

  • In Home Supportive Care Agency
  • Fort Lauderdale, FL
  • NPI 1316400203
  NPD (past)
• All Ways Hope LLC

  • Mental Health Counselor
  • Stuart, FL
  • NPI 1477313880
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309910400000",
    "number": "1619029683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4104 SE CENTERBOARD LANE",
            "address_2": "SUITE 205",
            "city": "STUART",
            "state": "FL",
            "postal_code": "34994",
            "telephone_number": "772-219-0779",
            "fax_number": "772-221-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "759 SW FEDERAL HWY",
            "address_2": "#203",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942914",
            "telephone_number": "772-219-0779",
            "fax_number": "772-221-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "JUDITH",
        "middle_name": "V",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2011-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW3067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211492500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "088978",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEHAVIORAL HEALT",
            "identifier": "112262000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna Walker, RBT
• Elysha Walker
• Jadyn Walker
• Jazzanay Cherish Unique Walker
• Kimberly Walker
• Antwion Nathaniel Wallace
• Cathleen Marie Wallen Beauseigneur, LCSW
• Betty L Wallen, CRNA
• Joshauna Audreyann Wallen
• Samanthia Wash Waller

• Clinical Social Worker in Stuart, FL
• Providers in Stuart, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.